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Dipyrone (metamizole) is a nonsteroidal anti-inflammatory drug. The mechanism of action of dipyrone is thought to be similar to that of other NSAIDs: inhibition of the production of prostaglandins. It is commonly used in the horse as an antipyretic, analgesic, and anti-inflammatory.
Dipyrone is a very mild NSAID. Because of its very mild analgesic properties it is unlikely to mask abdominal pain due to a surgical problem. Traditionally, dipyrone has been thought to also have anti-spasmodic properties on the smooth muscle of the gastro-intestinal tract, which has been the basis for its common use in cases of mild colic. Although research evidence does not support any claim of anti-spasmodic activity, many clinicians consider it a very useful drug precisely for this reason. Flunixin meglumine is a NSAID with stronger analgesic properties that is also used to treat GI pain.
Dipyrone may be used in foals and in adult horses to reduce fevers. It is not commonly used for the treatment of musculoskeletal pain. Dipyrone may be given IM, IV, or subcutaneously.
• The most common side effect for dipyrone is injection site reactions. These reactions usually respond to hot compresses and NSAIDs.
• Prolonged use of dipyrone may cause bone marrow suppression (leukopenia, agranulocytosis). Animals receiving prolonged courses of dipyrone should be followed with regular CBCs.
• Although dipyrone is a very mild NSAID, these types of drugs should be avoided or very carefully monitored in animals with liver disease, kidney disease, or GI problems. Therapy should be stopped at the first sign of any adverse reaction (anorexia, oral ulcers, depression, decreased plasma protein, increased creatinine, anemia, leukopenia).
• Dipyrone should be given slowly when used intravenously. Rapid administration may cause seizures.
• Dipyrone should be used with caution in older or debilitated animals particularly those with cardiac disease.
• Dipyrone should not be used in animals with history of blood or bone marrow abnormalities.
• Dipyrone was once considered a "masking drug" in racehorses. If used in racehorses, inquiry should be made with the individual racing jurisdiction regarding withdrawal periods. Older information suggests a 5-day withdrawal period.
• Dipyrone should not be used concurrently with chlorpromazine due to potentially serious hypothermia.
• Dipyrone should not be used in conjunction with phenylbutazone or barbiturates.
Convulsions have been reported following acute overdose.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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